Date of Award


Document Type


Degree Name

Doctor of Philosophy (PhD)


Speech and Hearing Science


Speech and Language Pathology

Research Advisor

Jillian H. McCarthy, Ph.D.


Ellen Hamby, PhD Mark Hedrick, PhD Rebecca Koszalinski, PhD Kevin Reilly, PhD


Augmentative and alternative communication; Computer-based learning modules; interdisciplinary; collaboration; nursing education


Purpose and Rationale. To develop, implement, and assess computer-based learning modules (CBLs) on augmentative and alternative communication (AAC) with pediatric nurses and nursing students for knowledge outcomes, self-efficacy, and perceived relevance and effectiveness. Effective communication ensures all parties can understand and express themselves clearly, through any means necessary, often including AAC tools, supports, and strategies. Communication is essential in healthcare but there is limited research with pediatric nurses. Previous research with a single hospital indicated a need for nurse education on AAC. This research used focus groups and interviews to understand pediatric nurse and nursing student knowledge about AAC. The qualitative data was analyzed and used to create short CBLs on AAC which were piloted and implemented with both groups.

Study Population. Fifteen pediatric nurses and nursing students participated in qualitative data collection, five pediatric nurses and nursing students in the feasibility pilot of the CBLs, and 69 participants in the CBL implementation phase. Participants were 18 years of age or older and a pediatric nurse or nursing student.

Research Design and Study Procedures. Following Institutional Review Board (IRB) approval, qualitative data collection included focus groups and interviews with pediatric nurses and nursing students to gain feedback on participant experience with AAC. Data was gathered, transcribed using word-for-word transcription, and analyzed using grounded theory and thematic analysis to prioritize information for inclusion in CBLs for further implementation. CBLs were created using the analyzed qualitative data, piloted with five participants, and implemented with 69 participants using a pre-test, post-test design for three short online modules with both groups.

Results. Data analysis included thematic analysis of qualitative data using grounded theory. Statistical analyses included repeated measures analysis of variance (ANOVA), independent samples t-tests, multivariate analysis of variance (MANOVA), and descriptive statistics. Participants learned new information from pre- to post-test, increased their perceived self-efficacy to use the information provided, and overall felt it was relevant to their clinical practice and an effective method of providing information.

Declaration of Authorship

Declaration of Authorship is included in the supplemental files.




2021-005-Simmons-DOA.pdf (124 kB)
Declaration of Authorship